In patients with COVID-19 who go on to develop hypoxic respiratory failure, one of the strategies to improve the oxygen saturations is repositioning the patient into the prone position, in both ventilated and awake patients. The benefits of proning include reduced atelectasis at the posterior segments of the lung, and improved V/Q mismatch.
Indications for awake proning:
Absolute contraindications for awake proning:
Relative contraindications for awake proning:
Proning is just one position in a rotation of positions that are recommended for a patient with COVID-19 who is awake, and the other positions are upright, left position and right position. If patient fulfils criteria for proning ask the patient to switch positions every 30 minutes to two hours. Monitor oxygen saturations 15 minutes after each position change to ensure oxygen saturation has not decreased.